[Detection of healthy carriers in progressive muscular dystrophy 24 families].
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Chile↗
Biomedical subjects
M Devilat
Publications and source records attributed to M Devilat.
[Adverse effects of valproic acid in epileptic infants and adolescents].
Although valproic acid as well as its derivatives are effective in the treatment of some epileptic seizures, they are not free of adverse side effects. The purpose of this work was to describe the collateral clinical effects of valproic acid, the associated changes that take place in some serum laboratory parameters, and correlations among these adverse clinical effects, drug serum level and therapeutic response. One hundred patients aged 7 months to 19 years (average 5 year and 6 month old) were followed for at least 13 months. Clinical collateral effects were observed in 14% patients, anorexia and hair loss being the most frequent. One third of patients showed raised serum alkaline phosphatase and transaminases values, while lower than normal prothrombin time and platelet counts were detected in 4% and 1% of patients, respectively. In one patient treatment was interrupted because of low platelet counts which persisted in spite of drug withdrawal, but basal counts were not done, so it is not possible to establish causal relationships between both events. No correlation between adverse clinical symptoms and valproic acid plasma levels was observed. In spite of the fact that basal laboratory values were not known and that abnormal tests were not repeated for confirmation, collateral clinical effects and laboratory findings associated to treatment with valproic acid seemed not severe in this series. Anyway, taking into account drug characteristics, it should always be used with caution.
Adolescent↗
[Treatment of status epilepticus with rectally administered diazepam].
Rectal administration of diazepam is a good alternative to intravenous acute treatment in severe epileptic crises, but there is scarce information about its usefulness in status epilepticus. Treatment with rectal diazepam, 0.6 to 0.8 mg x kg of body weight as a single drug, in 10 children with 13 episodes of status epilepticus, defined as epileptic crises lasting 30 or more minutes (ten of these were generalized tonic and clonic, two were unilateral tonic and clonic, and one was of the partial complex type) is described. Nine status epilepticus episodes subsided at an average 4.4 minutes after the drug was given; in 3 cases there were no favourable effects, and one case recurred after initial response. There were no significant complications, with the exception of slight respiratory depression in a patient with encephalitis. In spite of the small size of the sample, these results suggest that rectal diazepam is an effective alternative to intravenous drug administration in the management of status epilepticus whenever venous access is difficult.
Administration, Rectal↗
[Auditory brainstem evoked potentials in hearing loss after bacterial meningitis].
Fourteen children with acute bacterial meningitis, were examined for auditory brainstem evoked potentials (ABEP) during their initial hospital course (days 3 to 24 from admission). Different degrees of neurosensory hypoacusia were detected in 8 patients (57.14%). Children aged less than one year seemed to be more susceptible to auditory deficit. In 6 children a second ABEP was done after a time interval which ranged from 20 to 570 days after the first one and all them showed residual hypoacusia. The short term evolution suggests that the acute process can be prolonged for more than 1 month after hospital admittance, and the altered auditory function tends to persist over the mid term. It is concluded that despite this research's methodological limitations. ABEP seem useful for early detection of postmeningitical neurosensory hypoacusia and follow-up of these patients.
Child, Preschool↗
[Juvenile myoclonic epilepsy. Life difficulties and response to treatment].
Juvenile myoclonic epilepsy (JME) may have different forms of clinical expression and produces different kinds of life difficulties. Both eventualities have not been sufficiently described in the literature. Treatment with valproic acid is useful but requires strict compliance of medical instructions. Thirty two patients with this disease, are presented in order to describe their presenting forms, associated life handicaps and the results of their treatment. The disease may first present as tonic-clonic, complex absence or complex partial seizures, followed months or years later, by typical myoclonic crisis or as JME to which other kinds of epileptic crisis may or not be added after some time. Twenty four (75%) patients had 38 life difficulties, these being, mainly, objects dropped from hand, burns and parental aggression. Eighteen (56.25%) patients had relapses during treatment. In 14 cases (77.77%) relapses were due to noncompliance, 8 (57.19%) patients couldn't afford the cost of valproic acid. Knowledge of the presenting forms of the disease may favor opportune diagnosis and treatment, which would prevent life difficulties. Relapses are mainly due to noncompliance and economic reasons.
Adolescent↗
[Opinion about epilepsy among 3 groups of mothers and the effects of education].
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Attitude to Health↗